Provider Demographics
NPI:1245667799
Name:ESPINOZA, LISBETH (CAOHC,LVN)
Entity type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:CAOHC,LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8638 CEDARVALE DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75708-7204
Mailing Address - Country:US
Mailing Address - Phone:903-877-5817
Mailing Address - Fax:903-877-7508
Practice Address - Street 1:11937 US HIGHWAY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7930
Practice Address - Fax:903-877-7508
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305524164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse